May go unnoticed and untreated

Children with depressive disorders lack interest in activities they previously enjoyed, criticise themselves, and are pessimistic or hopeless about the future. They may feel sad or irritable. Problems at school arise from indecision and difficulties with concentration. Depressed children tend to lack energy and have problems sleeping. They may have stomach aches or headaches. Morbid thoughts may progress to suicidal thinking and even suicide attempts.1 For various reasons, some adults find it hard to accept that children may experience unpleasant psychological states such as depression. Compared with the literature on depression in adults, evidence from randomised controlled trials for the efficacy of treatments for depression in young people is scarce.

A community survey of Australian children found that 3.7% of boys and 2.1% of girls aged 6-12 years had experienced a depressive episode in the previous 12 months.2 The average duration of a depressive episode in young people is about nine months, with a 70% …